Was Your Ovarian Cancer Misdiagnosed

Was Your Ovarian Cancer Misdiagnosed

Was Your Ovarian Cancer Misdiagnosed?
Two Percent of​ All Female Newborns in​ the​ United States Are at​ Risk of​ Getting Ovarian Cancer
As many as​ 30,000 U.S .​
women will be diagnosed with ovarian cancer this year .​
In 2018, between 15,000 and​ 16,000 women are likely to​ die from this silent killer .​
Ovarian cancer is​ the​ 5th leading cause of​ death among women, and​ it​ is​ responsible for​ about five percent of​ all cancer deaths .​
Chances are your doctor may have misdiagnosed you .​
That is​ often the​ case .​
a​ recent British study found 60 percent of​ all U.K .​
general practitioners had misdiagnosed their patients .​
Three-quarters of​ British doctors surveyed incorrectly assumed that symptoms only occurred in​ the​ late stages of​ ovarian cancer .​
Based upon that information, it​ should be no surprise that Britain has one of​ the​ lowest survival rates for​ ovarian cancer in​ the​ Western World – of​ 6,800 cases diagnosed each year, more than 4,600 die.
A similar discovery was made by University of​ California researchers, who announced last year, Four in​ 10 women with ovarian cancer have symptoms that they tell their doctors about at​ least four months — and​ as​ long as​ one year — before they are diagnosed .​
According to​ their study of​ nearly 2,000 women with ovarian cancer, the​ researchers discovered physicians:
• First ordered abdominal imaging or​ performed gastrointestinal procedures instead of​ the​ more appropriate pelvic imaging and/or CA-125 (a blood test that can detect ovarian cancer).
• Only 25 percent of​ patients, who reported ovarian cancer symptoms four or​ more months before diagnosis, were given pelvic imaging or​ had CA-125 blood tests.
Patients with early symptoms are frequently misdiagnosed .​
Abdominal imaging or​ diagnostic gastrointestinal studies are less likely to​ detect ovarian cancer .​
According to​ the​ American Cancer Society’s website, the​ most common symptom is​ back pain, followed by fatigue, bloating, constipation, abdominal pain and​ urinary urgency .​
These symptoms tend to​ occur very frequently and​ become more severe with time .​
Most women with ovarian cancer have at​ least two of​ these symptoms.
By the​ time a​ woman reaches the​ fourth stage of​ ovarian cancer, her first-line treatment is​ often Carboplatin, Paclitaxel and​ Cisplatin as​ the​ specific chemotherapy for​ ovarian cancer .​
In the​ first stage, cancer is​ contained inside one or​ both ovaries .​
By stage two, the​ cancer has spread into the​ fallopian tubes or​ other pelvic tissues, such as​ the​ bladder or​ rectum .​
When the​ cancer has spread outside the​ pelvis area into the​ abdominal cavity, especially when tumor growths are larger than two centimeters on the​ lining of​ the​ abdomen, then ovarian cancer has reached stage three .​
The fourth and​ final stage of​ ovarian cancer is​ reached when the​ cancer has spread into other body organs, such as​ the​ liver or​ lungs.
If detected early, survival rates can be as​ high as​ 90 percent .​
Detected in​ the​ advanced stage, the​ survival rate falls to​ between 30 and​ 40 percent .​
Various imaging tests such as​ computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and​ ultrasound studies can confirm whether a​ pelvic mass is​ present .​
a​ laparoscopy can help a​ doctor look at​ the​ ovaries and​ other pelvic tissue to​ in​ order to​ plan out a​ surgical procedure, or​ to​ determine the​ stage of​ the​ ovarian cancer .​
a​ biopsy, or​ tissue sampling, would confirm if​ there is​ cancer in​ your pelvic region, and​ would help determine how advanced it​ is​ .​
An elevated CA-125 blood test typically suggests the​ cancer has progressed to​ the​ advanced stage.
About 50 percent of​ ovarian cancer patients are already at​ an​ advanced stage by the​ time a​ correct diagnosis is​ made .​
Only 10 to​ 14 percent of​ women with advanced cancer are likely to​ survive more than five years.
Evaluation of​ Therapies
While research shows drinking black (or green) tea or​ taking the​ herbal supplement gingko biloba may be useful, as​ a​ preventative measure, or​ to​ reduce risk, a​ woman has few choices when her cancer has moved to​ the​ advanced stage .​
In the​ first stage, a​ woman faces surgical removal of​ the​ tumor, and​ possibly one or​ both ovaries, to​ increase her chances of​ survival .​
Beyond that, her choice is​ chemotherapy.
One major problem with chemotherapy is​ the​ side effects .​
The more advanced the​ cancer, the​ weaker one may be, reducing the​ survival rate potential .​
Survival rates have not changed very much over the​ past fifteen years .​
Chemotherapy can increase survival time by as​ much as​ 50 percent .​
But, quality of​ life suffers .​
The side effects and​ increased toxicity, accompanying chemotherapy, reduce how one spends the​ prolonged survival time.
Some of​ Paclitaxel’s minor side effects, as​ reported by Medline Plus, may include nausea, vomiting, loss of​ appetite, change in​ taste, thinned or​ brittle hair, pain in​ the​ joints of​ the​ arms or​ legs, changes in​ the​ color of​ nails, and/or tingling in​ the​ hands or​ toes .​
More serious side effects may include mouth blistering or​ fatigue .​
Some alarming side effects could include unusual bleeding or​ bruising, dizziness, shortness of​ breath, severe exhaustion, chest pain, or​ difficulty swallowing .​
The most common side effect of​ Paclitaxel is​ a​ decrease of​ blood cells.
Carboplatin has its own list of​ side effects .​
It can reduce platelet production, which can interfere with your blood’s ability to​ clot .​
You may become anemic, feeling tired or​ breathless .​
Nausea, vomiting, loss of​ appetite and​ a​ general feeling of​ weakness are common with this chemotherapeutic agent.
The latest breed of​ drugs, such as​ Eli Lilly’s Gemzar, are hardly getting praise .​
On March 10th, the​ Food and​ Drug Administration (FDA) said it​ was skeptical of​ the​ benefits Eli Lilly’s Gemzar, which was being used with Carboplatin to​ treat ovarian cancer patients .​
The FDA felt the​ 2.8 months increased survival time, provided by the​ Gemzar/Carboplatin combination failed to​ offset the​ treatment’s increased toxicity.
In January, the​ New England Journal of​ Medicine reported on a​ remarkable new delivery system of​ chemotherapy, called the​ intra-abdominal, or​ intraperitoneal, chemotherapy .​
Those who received the​ belly bath as​ it​ is​ now being called by the​ media can survive 16 months longer than those receiving intravenous chemotherapy .​
The major drawback is​ that 60 percent of​ the​ women in​ the​ study were unable to​ complete all six cycles of​ this chemotherapy .​
Those who did survived longer, but only two in​ every five women were able to​ advance to​ the​ end phase of​ the​ therapy.
One novel approach, now in​ Phase III trials at​ more than 60 research centers across the​ United States, is​ OvaRex ® MAb, a​ murine monoclonal antibody, a​ type of​ biotech drug derived from mouse cells .​
It is​ being tested by highly regarded United Therapeutics, based in​ Silver Springs, Maryland .​
Their lead drug Remodulin, an​ injection which treats pulmonary arterial hypertension, is​ currently being marketed inside and​ outside the​ United States .​
More than $32 million has been spent researching, and​ on the​ development of, OvaRex and​ may have it​ available on the​ market by 2018.
OvaRex was developed in​ Canada by a​ company called ViRexx Medical Corp, and​ first tested in​ that country .​
According to​ Dr .​
Lorne Tyrrell, Chief Executive of​ ViRexx, the​ whole study has been set up with the​ FDA .​
This is​ a​ study where the​ drug has been given fast track approval and​ orphan drug status .​
Dr .​
Tyrrell is​ also on leave (until OvaRex become commercially available) as​ a​ Professor of​ Medical Microbiology and​ Immunology at​ the​ University of​ Alberta, and​ Director of​ the​ National Centre of​ Excellence for​ Viral Hepatitis Research.
OvaRex was tested in​ Canada, prior to​ the​ current Phase III trials in​ the​ U.S .​
There have been a​ number of​ patients that have received OvaRex, said Dr .​
Tyrrell, We’ve had really no adverse effects from these patients .​
Dr .​
Tyrrell explained the​ procedure, After being injected intravenously, OvaRex binds to​ an​ antigen circulating in​ the​ blood .​
An antibody’s general purpose is​ to​ neutralize an​ antigen .​
After an​ OvaRex injection, the​ murine monoclonal antibody binds to​ the​ CA-125 antigen.
In a​ way the​ body is​ tricked .​
But, the​ body is​ tricked in​ order to​ help save itself from the​ harmful antigen .​
When the​ OvaRex antibody is​ bound to​ the​ CA-125 antigen, the​ new combination is​ identified as​ a​ harmful unit .​
Before then, the​ antigen wanders through the​ body, without alerting the​ body’s defense systems, the​ dendritic cells, to​ attack and​ destroy the​ harmful antigen .​
Because the​ body is​ trained to​ identify and​ zero in​ on a​ foreign protein, in​ this case a​ mouse protein, it​ alerts the​ dendritic cells .​
Until then, the​ dendritic cells tolerate the​ cancerous cells .​
The tolerance is​ what permits the​ cancer to​ spread throughout the​ body.
OvaRex seeks to​ break that tolerance .​
The murine monoclonal antibody is​ designed to​ target and​ bind exclusively to​ free floating CA-125 antigen .​
The dendritic cells refuse to​ tolerate the​ foreign protein .​
When the​ antibody binds with the​ free-floating antigen, the​ dendritic cells recognize the​ complex (antibody plus antigen) as​ being foreign and​ engulf the​ new unit .​
The dendritic cells break down the​ key proteins of​ this unit, presenting all parts on the​ cells surface .​
At the​ point, the​ body’s killer T-Cells are alerted to​ fight the​ internal threat to​ the​ body .​
Once activated, the​ T-Cells will replicate and​ create more killer T-Cells .​
Any tumor cells expressing the​ CA-125 antigen is​ targeted for​ destruction .​
The army of​ T-Cells move to​ attack the​ ovarian cancer tumor.
The principle behind OvaRex is​ to​ re-program the​ immune system to​ harness the​ body’s defenses to​ prevent the​ growth and​ spread of​ the​ ovarian cancer .​
Will it​ cure ovarian cancer? In most cases, it​ will be a​ delay, explained Dr .​
Tyrrell .​
However, I​ think that, and​ everyone hopes that, often in​ some of​ these tumors, you’re making incremental progress through careful clinical trials and​ adding new therapy .​
Each thing we do that improves the​ outcome when you start to​ look at​ the​ long term benefits of​ these, we hope that one day we will be able to​ cure this disease .​
We think this is​ a​ step .​
This has the​ potential to​ be an​ important step at​ helping to​ stimulate immune response to​ achieve a​ better outcome .​
Hopefully, one day we can improve that to​ where it​ is​ a​ cure.

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